Most asbestos lawsuits in the United
States are being brought by claimants who are probably not sick, a
study warns. The researchers found that experts hired to interpret
lung X-rays in these cases are vastly exaggerating the damage
caused, with potentially devastating effect on the companies
required to pay compensation.
Asbestos, once widely used as a fireproof
insulator, is made of microscopic mineral fibres that are easily
inhaled and work their way deep into the lung. Once lodged in the
lung tissue, they are attacked by the body's defences and become
surrounded by scar tissue.
The particles are particularly nasty
because they are long and sharp, and can cut their way through lung
tissue, unlike more spherical particles such as coal dust. The
cumulative toll on health is called asbestosis; sufferers' lung
function is affected, they cough and wheeze, and may even die. Some
people also get a specific type of cancer, called mesothelioma.
The health effect commonly take a few decades to appear.
The peak exposure in the United States, for workers in shipyards,
building sites, and asbestos mining and manufacturing, was between
the 1940s and the 1970s, so the number of emerging cases should now
be dropping. Instead, more and more people are bringing cases every
year.
B-readers
To assess damage to a potential
claimant's lungs, his or her chest is X-rayed and examined by a
certified expert called a "B-reader", hired by the claimant's
lawyer. If the lungs are judged to be harmed by asbestos, the lawyer
seeks compensation for the claimant from their former employer, or
from the numerous trusts set up for workers suffering from the
disease.
Hundreds of thousands of people sue every year and billions
of dollars are awarded in compensation, with disastrous effects on
many of the companies involved. According to the study, published in
August's Academic Radiology2,
"More than 60 US companies have sought voluntary bankruptcy to deal
with such claims."
The problem, according to Otha Linton,
co-author of the paper and director of the International Society of
Radiology, is that most of these claimants aren't actually sick.
Linton and his team studied X-ray films of the lungs of 492
claimants. B-readers retained by the plaintiffs' lawyers had
diagnosed 95.9% of them with "parenchymal abnormalities", enough
scar tissue to make them officially ill. Linton then gave the same
films to six B-readers who had no idea what the study was about.
The interpretation of the independent experts was
staggeringly different. They diagnosed parenchymal abnormalities in
only 4.5% of the cases.
Biased readings?
Reading
X-rays can involve a degree of subjectivity, and B-readers do
sometimes disagree on how badly damaged a lung is. But Linton says
that such a fundamental difference in interpretation is unheard
of.
The finding is as disquieting as it
is startling
Murray
Janower and Leonard
Berlin
He believes the results show that the B-readers hired by
claimants' lawyers are producing biased readings, whether
intentionally or not. And if one expert does not find damage to a
lung, a lawyer is likely to keep trying until he finds an expert who
does, Linton says. "If I am a plaintiff's lawyer, I am going to find
witnesses who will, rightly or wrongly, honestly or dishonestly,
agree with me."
The finding is "as disquieting as it is
startling", say radiologists Murray Janower and Leonard Berlin in an
editorial that accompanies the study2,
although they are careful not to say that the data point to outright
fraud.
The latest paper is not the only study that casts doubt on
certain B-readers. A 2002 report by the non-profit RAND Institute
for Civil Justice, and a 1990 paper in the Journal of Occupational
Medicine3
both conclude that lots of healthy people, and lawyers, are getting
cash they do not deserve.
However, Dave Chervenick from Goldberg,
Persky and White, a law firm based in Pittsburgh, Pennsylvania, that
specializes in asbestos cases, says his firm's screeners find
asbestos damage in only 15% of cases. He does not think there is a
widespread problem. "It's my sense that not a whole lot of this is
going on," he says.
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The finding is as disquieting as it
is startling 
